Synacthen versus using Hydrocortisone

[Kevlin]

Hello again Paul

Nice to see you here tonight aswell

No point doing a Synacthen now on HC.

Does this mean: it is no point in taking a Synachen-test when using HC?

I have used HC for 1,5 year - in addition to NDT.
Last week I took a Synachen test at the hospital (because they wanted me to - not my wish).
In the papers sent to me (some weeks ago) I was informed that I should not take any HC 24 hours upfront.
What happended is that I misunderstood this, so I had taken my last HC 12 hours before the testing began....

But as I read your sentence "No point doing a Synacthen now on HC." - either way it will be useless information

[Paul Robinson]

Hello again Paul

Nice to see you here tonight aswell



Does this mean: it is no point in taking a Synachen-test when using HC?

I have used HC for 1,5 year - in addition to NDT.
Last week I took a Synachen test at the hospital (because they wanted me to - not my wish).
In the papers sent to me (some weeks ago) I was informed that I should not take any HC 24 hours upfront.
What happended is that I misunderstood this, so I had taken my last HC 12 hours before the testing began....

But as I read your sentence "No point doing a Synacthen now on HC." - either way it will be useless information

If your adrenals pass the Synacthen test then it is good information because the HC will be partially suppressing your adrenal function and making your adrenal response weaker than it should be. If you pass then your 'adrenal muscles' are pretty good. If you fail by a little then this may be the HC that has done this. If you fail massively then this may be Addison's.

OK?

[Blondie]

I had my synachten test about 6-8 weeks after I started on cortison (witch meens that the adrenals could'nt be that suppressed). I did not know that the doctor wanted a synachten test, so I had taken one dose of cortison in the morning, and one an hour and a half before the test. The "zero value" was 200-something, witch would be normal that time of day. After the injection the bloodresult was 560 (ref >550). The doctor told me that he would consider the fact that I had taken cortison before the test. And he did. His interpetation was that I had suppressed adrenal function because of using cortison. So whatever your result is, Kevlin. You can be sure that however they read the result, it wan't be in your benefit.

[Paul Robinson]

Hello again Paul

Nice to see you here tonight aswell



Does this mean: it is no point in taking a Synachen-test when using HC?

I have used HC for 1,5 year - in addition to NDT.
Last week I took a Synachen test at the hospital (because they wanted me to - not my wish).
In the papers sent to me (some weeks ago) I was informed that I should not take any HC 24 hours upfront.
What happended is that I misunderstood this, so I had taken my last HC 12 hours before the testing began....

But as I read your sentence "No point doing a Synacthen now on HC." - either way it will be useless information

Hi Kevlin, yes you have to be free from HC for several weeks (at least two I think( before a Synacthen test is considered to be accurate. The HC causes the pituitary to stop sending as much ACTH signal/request to the adrenal glands and this caused the adrenal glands to produce less cortisol. Over a long period the adrenal glands can get smaller due to the use of HC, so there is also the concern of adrenal damage due to long term HC use. Once the HC is stopped (which has to be done very slowly over many weeks), then after a few weeks the adrenals get the proper signal of ACTH and begin to produce as much cortisol as they can. Only then can a Synacthen test result be taken seriously. Your doctor should have told you all of this before the test. The process of reducing HC like this is called 'weaning' and it needs to be done very slowly and carefully to avoid causing serious problems with the patient's health.

[Vigdis]

Another thing, if you do not wean off slowly, you have a high risk to go from bad to even worse. You have an andreal insufficieny, and you might risk to get an secondary adrenal insufficiency. It is much worse. So all of us who need hydrocortison have to be extremly careful to not wean off too quickly.